CN1972714A - Methods of treating autoimmune and inflammatory diseases - Google Patents
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Abstract
This invention provides method of treatment of autoimmune diseases and/or inflammatory disorders.
Description
Invention field
The present invention relates generally to and utilize CD3 regulator such as anti-cd 3 antibodies to come inducing immune tolerance and adjusting immunoreation, treat autoimmune disease and/or inflammatory diseases.
Background of invention
The immune system high complexity by stringent controlled, has the defective that many alternative route can remedy system's other parts.If yet activation sometimes, immunoreation also becomes the cause of disease of some diseases or other defective mode.This disease or defective mode for example be autoimmune disease, the rejection after transplanting, to harmless antigenic anaphylaxis, psoriasis, chronic inflammatory disease such as atherosclerosis and common inflammation.Relate under improper or undesirable immunoreactive situation in these situations and other, need to carry out immunosuppressant clinically.
Therefore, need can be used for treating the compositions of immune correlated disease and/or disease.
Summary of the invention
The present invention is based on following discovery, promptly CD3 expresses or active adjusting causes the reduction of atherosclerotic plaque development in the inhibition of inflammation in the clinical uveitis rat model and the clinical atherosclerosis mouse model.Therefore, the invention describes the method for inflammation in prevention or the inhibition bodily tissue.The feature of Inflamed tissue is to organize rubescent, pain and swelling.Uveitic being characterized as among visual acuity decline, vitreous body (rear portion of eye) and the anterior chamber has cell and muddy thing (fibrin, denatured protein).These tissues comprise ocular tissue such as uvea, heart tissue such as vein, tremulous pulse or blood capillary.
By cell or tissue being exposed to the CD3 regulator that causes proinflammatory cytokine to generate the amount of minimizing, anti-inflammatory cytokines increase or cause the amount of immunologic tolerance, inflammation-inhibiting reaction.
The invention provides by the CD3 express cell being exposed to and suppress the method that atheromatous plaque forms with the CD3 regulator.Be exposed to the CD3 regulator before compare, be exposed to CD3 regulator artery medicated porridge sample lump and be suppressed, the plaque volumes that links to each other with arterial wall reduces.
This cell can be any cell that can express CD3, for example lymphocyte such as T-cell.This T-cell is a circulation T-cell, promptly in blood and lymph.Perhaps, this T-cell also is present in the tissue, as lymph node, lymphatic ducts, lymphatic vessel and spleen.This tissue is the Inflamed tissue's tissue of risk of inflammation (or have).Exposure is meant cell or tissue is contacted with the CD3 regulator.Histiocyte directly or indirectly (being general) contacts with it.Cell can be in vivo, contact in the external or test tube.
The present invention has also described simultaneously prevention and has slowed down the method for inflammatory diseases symptom, and this method is to suffer from or the object of risky trouble inflammatory diseases by discriminating, and gives this object CD3 regulator.
The CD3 regulator is can reduce CD3 to express or active chemical compound.The activity of CD3 comprises the T-cell activation.The detection method of T-cell activation is known in this area.The CD3 regulator comprises for example anti-cd 3 antibodies.Give separately or unite to give CD3 regulator, be used for treating inflammatory diseases with another kind of antiinflammatory or immunosuppressant.For example, the CD3 regulator can give with the antirheumatic (DMARD) of corticosteroid, inhibin, interferon-, NSAID (non-steroidal anti-inflammatory drug) (NSAID), methotrexate, Ciclosporin A or the change state of an illness.
To liking mammal, as people, mice, rat, Canis familiaris L., cat, cattle, horse and pig.Object suffers from or risky trouble inflammatory diseases.Inflammatory diseases comprises cardiovascular inflammation, ophthalmia disease, gastrointestinal inflammation, hepatitis disease, lung inflammation, autoimmune disease or muscle inflammation.According to methods known in the art, detect as the inflammation of macroscopy, conjunctive tissue or the blood of tissue, can differentiate and suffer from or the object of risky trouble inflammatory diseases.Inflammatory symptom comprises the pain of affected tissue, rubescent and swelling.
Unless otherwise defined, all science and technology used herein and scientific terminology have with the present invention under the identical implication of those of ordinary skill common sense in the field.Though can be used for implementing or test the present invention with similar or identical method described herein and material, suitable method and material are narrated below.All publications mentioned in this article, patent application, patent and other list of references integral body by reference are attached to herein.If any conflict, be as the criterion with this description (comprising definition).In addition, material, method and embodiment only are illustrative, do not have restricted.
Other features and advantages of the present invention are conspicuous from following detailed Description Of The Invention and claims.
The accompanying drawing summary
Fig. 1 is the figure that describes clinical and histology's effect of anti-CD3 treatment in the rat uveitis model.
Fig. 2 describes the inhibiting figure of anti-CD3 treatment to the development of mouse aorta root atherosclerotic plaque.
Fig. 3 describes the inhibiting figure of anti-CD3 treatment to the existing atherosis damage progress of mice.
Detailed Description Of The Invention
The present invention's part is namely regulated CD3 expression or its activity and is caused immune response decline and antiphlogistic effects based on following discovery. More particularly, give alleviation that anti-cd 3 antibodies causes the indication relevant with uveitis and symptom and the reduction of atherosclerotic plaque development.
CD3 is the compound of at least five kinds of film Binding peptides in mature T-lymphocyte, each other and with the non-covalent combination of T-cell receptors. The CD3 compound comprises γ, δ, ε, ζ and η chain (being also referred to as subunit). When antigen when T-cell receptors is combined, CD3 compound transduction activation signals is to the cytoplasm of T-cell.
The CD3 conditioning agent
The CD3 conditioning agent refers to regulate CD3 expression or active material. Adjusting mean this material strengthen, improve, reduce or in and expression or the activity of CD3. The activity of CD3 comprises, the T-cell activation signal of for example transduceing. The activation of T-cell is defined by intracellular cGMP increase or the increase of cell surface IL-2 acceptor of calcium mediation. For example, the feature that the T-cell activation increases is to compare when not existing with compound, and the intracellular cGMP of calcium mediation and/or IL-2 acceptor reduced when this compound existed. For example utilize commercially available detection kit, measure by CIMA or flicker affinity and can measure intracellular cGMP. For example by the combination of mensuration with IL-2 receptor antibody such as PC61 antibody, can measure cell surface IL-2 acceptor.
The CD3 conditioning agent comprises for example anti-cd 3 antibodies or its fragment. Optional anti-cd 3 antibodies is strand anti-cd 3 antibodies, difunctional anti-cd 3 antibodies or the anti-CD3 antibody of heterozygosis (heteroconjugate). Antibody is the reactivity anti-cd 3 antibodies, and it induces the CD3 activity so. Perhaps, antibody is the neutrality anti-cd 3 antibodies, and it reduces the CD3 activity so.
Anti-cd 3 antibodies is well known in the art. Exemplary anti-cd 3 antibodies includes but not limited to OKT3, G4.18,145-2C11, Leu4, HIT3a, BC3, SK7, SP34, RIV-9 and UCHT1. Preferred anti-cd 3 antibodies is in conjunction with the epi-position identical with OKT3, G4.18,145-2C11, Leu4, HIT3a, BC3, SK7, SP34, RIV-9 and UCHT1. Antibody has preferably passed through humanization or Ma Yuanhua, to reduce the immune response of host's antagonist.
Those skilled in the art can understand, by determining whether antibody stops the combination of anti-cd 3 antibodies OKT3, G4.18,145-2C11, Leu4, HIT3a, BC3, SK7, SP34, RIV-9 and UCHT1 and CD3 antigen polypeptide or other t cell surface antigen polypeptide, might need not too much test and just can measure the former with the latter and whether have identical epi-position. The CD3 antigen polypeptide for example is the CD3 ε polypeptide compound with another CD3 subunit (such as γ, δ, ε, ζ and η chain). If tested antibody and antibody competition of the present invention, shown in the combination reduction of antibody of the present invention, then these two kinds of antibody are in conjunction with identical or closely-related epi-position. The specific another kind of method whether mensuration antibody has antibody of the present invention is, antibody of the present invention is carried out preculture with CD3 antigen polypeptide or t cell surface antigen polypeptide (polypeptide reaction common and of the present invention), add then antibody to be tested, measure antibody to be determined and whether be suppressed in conjunction with the ability of CD3 or t cell surface antigen polypeptide. If the combination of antibody to be tested is suppressed, probably this antibody to be tested and antibody of the present invention have epitope specificity same or functional equivalent.
Term used herein " antibody " refers to the immunocompetence part of immunoglobulin molecules and immunoglobulin (Ig) (Ig) molecule, and namely this molecule contains and can be combined with antigentic specificity the antigen-binding site of (generation immune response). This antibody comprises polyclone, monoclonal, chimera, strand, Fab、
F
ab′And F(ab′)2Fragment and FabExpression library. This antibody is fully human antibodies preferably. " specific binding " or " immune response " refers to the antigenic determinant reaction of antibody and one or more expectation antigens, and do not react (namely in conjunction with) with other polypeptide or with much lower affinity combination (Kd＞10-6)。
Term used herein " epi-position " comprises the albumen determinant of any energy specific binding immunoglobulin (Ig), scFv or T-cell receptors. Term " epi-position " comprise any can the specific binding immunoglobulin (Ig) or the protein determinant of T-cell receptors. The epi-position determinant is made up of the chemically reactive surface cohort of molecule such as amino acid or sugared side chain usually, usually has specific Three Dimensions Structure and specific charge characteristic. Think that antibody is combined with antigen specifically when dissociation constant≤1 μ M, preferred≤100nM, most preferably≤10nM.
Term used herein " immunity combination " and " immunity is in conjunction with character " refer to occur in the noncovalent interaction type between immunoglobulin molecules and its specific antigen.Immunity intensity of binding interactions or affinity can be with interactional dissociation constant (K
d) represent K wherein
dMore little, affinity is big more.With method well known in the art can quantitative selected polypeptide immune binding characteristic.A kind of such method comprises the speed that mensuration antigen binding site/antigenic compound forms and decomposes, and these speed depend on the same concentration of the complex gametophyte of two directional rates, interactional affinity and the geometric parameter of influencing.Therefore can and dissociate and bonded actual speed rate is measured " association rate constant " (K by calculating concentration
On) and " dissociation rate constant " (K
Off) (referring to Nature 361:186-87 (1993)).K
Off/ K
OnRatio can eliminate the irrelevant parameter of all and affinity, equal dissociation constant K
d(referring to Davies et al. (1990) Annual Rev Biochem 59:439-473).As equilibrium association constant (K
d)≤1 μ M, preferred≤100nM, more preferably≤10nM, most preferably≤100pM is during to about 1pM, thinks antibody specificity of the present invention in conjunction with the CD3 epi-position, radioligand is in conjunction with testing or the mensuration of similar experiment as is known to persons skilled in the art.
In order to improve the effectiveness of antibody in the treatment immune correlated disease, it is desirable that the effector function of antibody of the present invention is modified.For example, cysteine residues can be imported the Fc zone, thereby allow the formation of interchain disulfide bond in this zone.The same dimerization antibody of Chan Shenging can have the complement-mediated cell killing effect of the internalization ability of raising and/or raising and antibody-dependent cytotoxicity effect (ADCC) (referring to Caron et al. like this, J.Exp Med.176:1191-1195 (1992) and Shopes, J.Immunol., 148:2918-2922 (1992)).Perhaps, but engineered antibody makes it have two Fc zones, thereby can have the complement dissolving and the ADCC ability (referring to Stevenson et al., Anti-Cancer Drug Design, 3:219-230 (1989)) of raising.
The technology purification of antibody by knowing, as utilize the affinity chromatography of A albumen or G albumen (the IgG fraction of immune serum mainly is provided).Subsequently or as an alternative, specific antigen (for the target of immunoglobulin identification) or its epitope antigen can be fixed on the post, to come purification immunologic opsonin antibody by the immunoaffinity chromatography method.To the discussion of immunoglobulin purification referring to for example D.Wilkinson (Inc. publishes for The Scientist, The Scientist, PhiladelphiaPA, Vol.14, No.8 (April 17,2000), pp.25-28).
Therapeutic Method
By exposing, for example will organize or the CD3 express cell contacts with CD3 regulator (as anti-cd 3 antibodies), come inflammation-inhibiting.The CD3 express cell for example is a for example T-cell of lymphocyte.The T-cell comprises the T cytotoxic cell, t helper cell (for example Th1 and Th2) and natural killer T-cell.Tissue to be treated comprises gastrointestinal tissue's (as intestinal tissue), heart tissue (as vein, tremulous pulse or blood capillary), lung tissue, skin histology, ocular tissue's (for example iris, corpus ciliare or choroid) or hepatic tissue.
The feature that inflammatory suppresses is: compare with the tissue that does not contact the CD3 regulator, rubescent, the pain and the swelling of treated tissue reduce.Perhaps, for uveitis, inflammation suppresses to be characterised in that visual acuity strengthens, and cell and turbidity (fibrin, deformation protein) among vitreum (i.e. eye rear portion) and the anterior chamber reduce.Tissue or cell directly contact with the CD3 regulator.Perhaps, general gives CD3 regulator.Give the CD3 regulator of capacity, to reduce the generation of (for example suppressing) proinflammatory cytokine.Proinflammatory cytokine is the cytokine of inducing inflammatory reaction.Proinflammatory cytokine comprises for example interleukin (IL)-1, tumor necrosis factor (TNF), IL-17, IL-8 and macrophage inflammatory protein 1 α (MIP-I α).Perhaps, give capacity CD3 regulator, to increase the generation of (for example promoting) anti-inflammatory cytokines.Anti-inflammatory cytokines is to reduce the cytokine of inflammatory reaction.More particularly, anti-inflammatory cytokines control proinflammatory cytokine reacts and regulates immunne response.Anti-inflammatory cytokines comprises as interleukin (IL)-1 receptor antagonist, TGF β, IL-4, IL-6, IL-10, IL-11 and IL-13.In as serum, blood plasma or tissue, detect cytokine.Detect the generation of cytokine by method known in the art.For example, use and have specific immunoassay to measure the generation of cytokine proinflammatory cytokine or anti-inflammatory cytokines.
By cell and the muddiness among swelling, vitreum and the anterior chamber of tissues observed damage, local rubescent, affected area, come morphology evaluation inflammatory reaction.Perhaps, measure inflammatory reaction by C proteins C reactive or the IL-1 that measures in tissue, serum or the blood plasma.Numeration of leukocyte is returned baseline and is also shown alleviating of inflammation.
Perhaps, by organizing or the CD3 express cell is exposed to a certain amount of CD3 regulator,, reduce inflammation with redistribution and/or lip-deep CD3-T cell receptor complexes of scavenger cell (as lymphocyte) or CD3 complex.For example, the CD3 express cell is exposed to a certain amount of CD3 regulator, to regulate the contact of (promptly reducing) CD3 express cell-cell.The reduction of the cell surface expression of TcR or activity level means that TcR quantity or function reduce on the cell.Cell surface expression or the activity level of regulating CD3 mean change, for example reduce the CD3 quantity on the cell surface or its function.The internalization of CD3 or TcR when for example contacting with the CD3 regulator by cell reduces the amount of the CD3 that expresses on the cytoplasma membrane or TcR.CD3 was closed when perhaps, cell contacted with the CD3 regulator.Redistribution and/or the CD3-T cell receptor complexes of eliminating on the cell surface cause immunosuppressant or immunologic tolerance.Immunosuppressant is all can not produce routine immunization to all antigens to reply, and causes the symptom of one or more autoimmune diseases to be eased or inflammatory reaction alleviates.In case stop to treat with the CD3 regulator, immunosuppressant is reversible.Therefore, immunosuppressant is particularly useful for treating or alleviating the symptom of acute inflammation disease.On the contrary, immunologic tolerance is can not produce immunne response to specific antigen, causes the symptom of one or more autoimmune diseases to be eased or the inflammatory reaction reduction, and this still can long term maintenance when treatment stops.Treatment stops the back immunologic tolerance can keep at least 1 week, 1 month, 3 months, 6 months, 1 year, 2 years, 5 years or more for many years.Therefore immunologic tolerance is particularly useful for treating or alleviating the symptom of chronic inflammatory disease.Secular immunologic tolerance can obtain by solvable mechanism such as cytokine, perhaps can obtain by direct cell-cells contacting, and the latter relates to but is not limited to granzyme A, Cytotoxic cell proteinase-1 and/or perforin.
By giving object CD3 regulator, reducing or stoping atheromatous plaque is formation on the arterial wall at tremulous pulse.Speckle is the complex of cholesterol, other fatty material, calcium and blood constituent, is accumulated in the arterial wall lining.Atherosclerotic plaque reduces and to be defined as that the chamber is narrow to alleviate, and promptly the chamber broadens.The chamber width is measured by method well known in the art, for example angiography and doppler velocity waveform analysis.
This method is used to alleviate the symptom of multiple inflammatory diseases or autoimmune disease.Inflammatory diseases is acute or chronic.Inflammatory diseases comprises cardiovascular inflammation (atherosclerosis for example, apoplexy), gastrointestinal inflammation, the liver inflammatory diseases, lung inflammation (asthma for example, the injury of lung that air-conditioning causes), nephritis disease, ophthalmia disease (for example uveitis), the pancreas inflammation, the Genito-urinary inflammation, neural inflammatory diseases (multiple sclerosis for example, Alzheimer), allergy (allergic rhinitis/sinusitis for example, skin allergy disease (urticaria for example, angioedema, atopic dermatitis, contact dermatitis, psoriasis), food anaphylaxis, drug allergy, insect hypensensitiveness, mastocytosis), inflammation of bone (arthritis for example, osteoarthritis, rheumatoid arthritis, spondyloarthropathy), infect (for example bacterial infection or viral infection), oral cavity inflammatory diseases (perodontis for example, gingivitis or stomatitis) and transplanting (for example allograft or xenograft rejection or mother-fetus tolerance).
Autoimmune disease comprises for example acquired immune deficiency syndrome (AIDS) (AIDS, for having the virosis of autoimmune composition), alopecia areata, rhizomelic spondylitis, anti-phospholipid syndrome, the autoimmune bronzed disease, autoimmune hemolytic anemia, autoimmune hepatitis, Autoimmune Inner Ear Disease (AIED), autoimmune lymphoproliferative syndrome (ALPS), autoimmune thrombocytopenic purpura (ATP), Behet disease, cardiomyopathy, abdominal cavity sprue-dermatitis herpetiformis, confirmed fatigue dysimmunity syndrome (CFIDS), chronic inflammatory demyelination polyneuropathy (CIPD), the cicatrix pemphigus, cold agglutinin disease, the crest syndrome, Crohn disease, degos' disease, juvenile dermatomyositis, discoid lupus, essential mixed cryoglobulinemia, fibromyositis, thyroid function is unusual, acute idiopathic polyneuritis, chronic lymphocytic thyroiditis, the primary pulmonary fibrosis, idiopathic thrombocytopenic purpura (ITP), IgA nephropathy, insulin dependent diabetes mellitus (IDDM), juvenile chronic arthritis (Chauffard-Still disease), juvenile rheumatoid arthritis, the Meniere disease, mixed connective tissue disease, multiple sclerosis, myasthenia gravis, pernicious anemia, polyarteritis nodosa, polychondritis, polyglandular syndrome, polymyalgia rheumatica, polymyositis and dermatomyositis, primary agammaglobulinemia, primary biliary cirrhosis, psoriasis, arthritic psoriasis, the Raynaud phenomenon, the Reiter syndrome, rheumatic fever, rheumatoid arthritis, sarcoidosis, scleroderma (progressive systemic sclerosis (PSS) is also referred to as Sjogren's syndrome disease (SS)), the Sjogren syndrome, stiff-man syndrome, systemic lupus erythematosus (sle), pulseless, temporal arteritis/giant cell arteritis, ulcerative colitis, uveitis, vitiligo and Wegener granulomatosis.
Method described herein causes the seriousness of one or more symptoms of inflammatory diseases described herein or autoimmune disease to alleviate or alleviate.Determine curative effect in conjunction with any diagnosis or the known method for the treatment of concrete inflammatory diseases.Alleviating of one or more symptoms of inflammatory diseases or autoimmune disease shows that this chemical compound has clinical value.Inflammatory diseases and autoimmune disease use standard method to diagnose and/or monitor by doctor or veterinary usually.
Uveitis
Uveitis is defined as Uveal inflammation.Uvea is made up of three kinds of structures: iris, corpus ciliare and choroid.Iris is the coloured structure around the pupil, is found in preocular.Corpus ciliare is the structure that comprises muscle, be positioned at iris after, crystalline lens is focused on.Choroid is the layer that contains blood vessel that is positioned at a rear portion, between retina and sclera.Uveitic symptom comprises cell and muddiness (fibrin, denatured protein) and the retinal vasculitis among visual acuity decline, vitreum and the anterior chamber.Iris can be attached to (posterior synechia) on the phacocyst, or under the less situation attached to around cornea on (anterior synechia).In addition, iris stroma internal granuloma tuberosity can obviously exist.Intraocular pressure in the influenced eye reduces when beginning, and reason is capsulociliary secretion hypotonia.Yet along with continuing of reaction, inflammatory by-products can be accumulated in girder.If these fragments are obviously accumulated, if corpus ciliare recovers normal secretory volume simultaneously, intraocular pressure can sharply increase, and causes Secondary cases uveitis glaucoma.
Doctor or veterinary check by the ophthalmology and diagnose uveitis.
Vasculitis
Vasculitis is the inflammation of blood vessel.Inflammation is the disease that enters the hematoclasis tissue of tissue.These hemocyte great majority are leukocyte, and its circulation also is used as the main defence line of resisting infection.Under the normal condition, leukocyte destroys antibacterial and virus.Yet, can produce destruction if they invade to organize normally also.Vasculitis can influence very little blood vessel (blood capillary), medium sized blood vessel (small artery or venule) or trunk (tremulous pulse and vein).
Vasculitis can cause many different symptoms, and this depends primarily on the seriousness of affected tissue and tissue injury.Some patient is morbidity not, just occurs speckle once in a while on the skin.Other people is then very serious, has the damage of general symptom and major organs.Symptom comprises heating, common sensation poor (" discomfort "), muscle and arthralgia, inappetence, loses weight, ulcer (especially around ankle joint) can appear in fatigue, petechia, purpura, dead skin zone, arthralgia and with frank arthritis, joint heating and swelling, headache, conduct disorder, mental disorder, epilepsy, apoplexy, numbness and the tingling of pain.Vasculitic diagnosis is based on the result of personal history, cardinal symptom, comprehensive physical examination and specialized laboratory's test.Often occur blood dyscrasia when having vasculitis, comprise sedimentation rate rising, anemia, high leukocytic counting and platelet count.Blood count also can be used for discriminating and cause vasculitic immune complex or antibody in blood circulation, and whether measure the complement level unusual.
Atherosclerosis
Atherosclerosis causes deposit (the being speckle) accumulation of fatty material in the endarterium, cholesterol, cellular waste and calcium, has tangible inflammatory component.Final this fatty tissue erodable arterial wall reduces its elasticity (retractility) and the obstruction blood flow.Speckle also may break, and causes fragment to move to artery downstream.This is the common cause of heart attack and apoplexy.Also can form grumeleuse around the plaque deposition thing, further hinder blood flow,, then bring bigger danger if they come off and shift to heart, lung or brain.
Atherosclerosis does not show symptom usually, and blood flow seriously is obstructed in blood vessel.Skelalgia when atherosclerotic classical symptom comprises the chest pain when relating to coronary artery or relates to the lower limb tremulous pulse.Sometimes symptom only just can occur when motion.Yet, during some people's rest also symptom can appear.
Risk factor comprises smoking, diabetes, obesity, high blood cholesterol, high fat diet and a guy or family's HDH.Cerebrovascular, peripheral vascular disease, hypertension and the kidney disease that relates to dialysis all are the diseases relevant with atherosclerosis.
The therapeutic administration
The present invention includes and give object (as people or horse) and contain the CD3 regulator compositions of (the present invention is called " therapeutic compound ").
The effective dose of therapeutic compound is preferably about 0.1mg/kg to about 150mg/kg.Confessed as those skilled in the art, effective dose according to the use of route of administration, excipient and with other treatment give jointly change, described treatment comprises other antiinflammatory or the therapeutic agent that uses treatment, suppresses or alleviate concrete inflammatory diseases symptom.By differentiating the mammal (for example people patient or horse) that suffers from (or risky trouble) inflammatory diseases or autoimmune disease, carry out the therapeutic dosage regimen with standard method.
Use methods known in the art to give this individual drugs compositions.Chemical compound as described in preferred oral, rectum, nose, part or parenteral (as subcutaneous, intraperitoneal, intramuscular and intravenous) give.This chemical compound preventability administration perhaps gives after being checked through inflammatory result such as asthma attack or anaphylaxis.The optional medicine the ingredients of a mixture that is formulated as of this chemical compound is with the treatment inflammatory diseases.The formulation examples that is fit to parenteral comprises that active substance oozes saline solution, 5% glucose solution or another kind of standard drug and can accept aqueous solution in the excipient waiting.Also available standards solubilizing agent such as PVP or cyclodextrin transmit therapeutic compound as drug excipient.
Therapeutic compound described herein utilizes conventional method to be formulated as to be used for the compositions of other route of administration.For example, the therapeutic compound inhibitor is mixed with capsule or tablet is used for oral administration.Capsule can contain the medicine acceptable material of any standard, as gel or cellulose.Tablet can form by the mixture compacting with therapeutic compound and solid carrier and lubricant according to conventional methods.The example of solid carrier comprises starch and sugared, bentonite.This chemical compound is with duricrust tablet or capsule form administration, and it contains binding agent such as lactose or mannitol, conventional filler and tablet agent.Other dosage form comprises ointment, suppository, paste, spray, patch, cream, gel, can absorb sponge or foam.Known method in available this area is produced this dosage form.
Therapeutic compound comes into force when directly contacting with affected tissue.Therefore, this chemical compound of topical.For example, be the treatment contact dermatitis, with compound administration in influenced skin area.Perhaps, whole body gives therapeutic compound.In addition, chemical compound can by implant (directly being implanted in organ such as intestinal or the liver or subcutaneous implantation) but solid or absorption base administration, but described solid or absorption base slowly are discharged into this chemical compound in the adjacent tissue or surrounding tissue of object.
For example, be the treatment gastroenteritis disease, general gives chemical compound, or direct topical is in gastric tissue.The chemical compound of general administration can pass through intravenous, rectum or oral administration.For topical, the thin slice (wafer) that is soaked with medicine maybe can be able to be absorbed sponge and place directly and contact with gastric tissue.Diffusion and the erosion of polymer matrix and in vivo slowly discharge of the mixture of chemical compound or chemical compound by medicine on the thin slice.
For example by containing the solution of chemical compound to the liver pulse guard system infusion, the inflammation (being hepatitis) of treatment liver.Intraperitoneal infusion or lavation are used to reduce the inflammation of dispersivity intraperitoneal inflammation or prevention of surgical postoperative.
For the treatment of neural inflammation, but (promptly directly being injected in the cerebrospinal fluid) gives chemical compound in intravenous or the sheath.For topical, the thin slice that is soaked with medicine maybe can be able to be absorbed sponge and place directly and contact with central nervous system tissue.Diffusion or the erosion of matrix polymer and in vivo slowly discharge of the mixture of chemical compound or chemical compound by medicine on the thin slice.Perhaps, with known method medicine is injected brain or cerebrospinal fluid.For example, place the boring ring that has conduit, be connected in the drill hole that pierces in the skull mutually with skull as injection port.Wear membranous pin or the stylet that is positioned at boring ring top by inserting, fountain is linked to each other with conduit.Conduit tube component (as U.S. Patent No. 5,954,687 assemblies of describing) can provide flow path of the liquid, be suitable for fluid transport to brain, near or wherein selected location or from wherein transporting out, to allow to give within a certain period of time medicine.
For the treatment cardiac inflammatory, for example be expelled in the heart tissue by penetrating in the thoracic wall direct coronary artery, or use based on the method for standard percutaneous catheter and under cryptoscope instructs, inhibitor directly injected tissue (as cardiac muscle) or from inserting the supporter (stent) or the conduit infusion of body cavity, thereby transmission chemical compound.Can use any various coronary artery catheter or infusion catheter to come administration.Perhaps, medicine is smeared or is immersed on the supporter that places coronary artery.
Lung inflammation for example gives compounds for treating by inhalation.Chemical compound with the form of aerosol spray from pressure vessel or allotter that suitable propellant (for example gas such as carbon dioxide) is housed or from aerosol apparatus, transmit.
Ophthalmia disease is for example by topical administration eye compounds for treating.Medicine is with example gel, liquid or ointment form transmission.But ointment, colloid or drop of liquid can be with eye as known in the art transmission system such as applicator or eye drop device transmission.Perhaps, medicine transmits from be placed on the subconjunctival polymeric implant of eye.The optional compound general is transmitted.
By affected area there being specific approach treatment vasculitis.Generally speaking, vasculitis gives the CD3 regulator by intravenous and comes systemic treatment.
The CD3 regulator also can be united with one or more other therapeutic compound and given, described other therapeutic compound for example antiinflammatory or immunosuppressant.For example the CD3 regulator is united with any various known immune self-diseases and/or the treatment of inflammatory diseases and is given.The autoimmune disease that uses with the inventive method and/or the suitable known treatment of inflammatory diseases include but not limited to methotrexate, Ciclosporin A (comprising that for example ciclosporin microemulsion and Ta Ke are not taken charge of), corticosteroid, inhibin, interferon-, NSAID (non-steroidal anti-inflammatory drug) (NSAID) and change the antirheumatic (DMARD) of the state of an illness.Other treatment is before giving the CD3 regulator, give afterwards or simultaneously.
The beneficial effect of administering drug combinations includes but not limited to derive from the pharmacokinetics or the pharmacodynamics combined effect of therapeutic agent combination.The administering drug combinations of these therapeutic agents generally carries out within official hour section (normally several minutes, a few hours, a couple of days or several weeks, according to selected combination is different decide).The purpose of " therapeutic alliance " may be that (but generally not being) comprises and give the part of two or more these therapeutic agents as the separate single therapeutic scheme, and is accidental or at random caused administering drug combinations of the present invention." therapeutic alliance " purpose is to comprise and gives these therapeutic agents in order successively, and promptly wherein each therapeutic agent is in the different time administration, and the mode with the basic while of also comprising gives at least two kinds in these therapeutic agents or the described therapeutic agent.For example, can finish basic while administration by giving single capsule or a plurality of single capsule that contains each therapeutic agent of each therapeutic agent that object contains fixed proportion.
Described therapeutic agent can pass through identical or different administration.For example, the selected first kind of therapeutic agent of administering drug combinations can be by the intravenous injection administration, and other therapeutic agent Orally-administrable of administering drug combinations.Perhaps, all therapeutic agent Orally-administrables, or all therapeutic agents can be by the intravenous injection administration.The order of administration of therapeutic agent is very not crucial." therapeutic alliance " can comprise that also the administration with above-mentioned therapeutic agent further combines with other biological activity and non-drug therapy (for example operation or radiotherapy) again.When therapeutic alliance further comprised non-drug therapy, non-drug therapy can be implemented in suitable any, as long as the combined effect of the combination of therapeutic agent and non-drug therapy obtains beneficial effect.For example, in appropriate circumstances, when non-drug therapy is temporarily removed from the administration of therapeutic agent, perhaps a couple of days or even several weeks, still can obtain beneficial effect.
For evaluate patient whether from separately or unite and give to benefit the anti-cd 3 antibodies, available quantitative mode is checked patient's symptom and/or immunoreation, and relatively uses symptom and/or immunoreation before and after the Antybody therapy.For example, can measure patient's symptom by measuring with concrete symptom or a series of symptom among the patient before and after the anti-cd 3 antibodies treatment.For example, symptom is measured and monitored to available any canonical measure technology known in the art, as heating, arthralgia, myasthenia.In successful treatment, patient's states improve (be that measurement index descends, or the lasting improvement time increasing).
For example, in uveitis treatment, anti-cd 3 antibodies can with for example corticosteroid, methotrexate, Ciclosporin A, cyclophosphamide and/or inhibin administering drug combinations.Equally, suffering from disease such as Crohn disease or psoriasic patient can treat with the combination of anti-cd 3 antibodies of the present invention and Remicaid (infliximab) and/or Humira (adalimumab).
During the treatment rheumatoid arthritis, anti-cd 3 antibodies can be with corticosteroid, methotrexate, Ciclosporin A, inhibin, Remicaid (infliximab), Enbrel (Embrel) and/or Humira (adalimumab) co-administered.
Multiple sclerosis patients can be accepted anti-cd 3 antibodies and for example administering drug combinations of acetic acid glatiramer (Copaxone), interferon--1a (Avonex), interferon--1a (Rebif), interferon--1b (Betaseron or Betaferon), mitoxantrone (Novantrone), dexamethasone (Decadron), methylprednisolone (Depo-Medrol) and/or prednisone (Deltasone) and/or inhibin.
The type i diabetes patient or recessive autoimmune diabetes (LADA) patient that is grown up also give second kind of medicine, as GLP-I or beta cell dormancy chemical compound (promptly reducing or suppress the chemical compound of insulin release, as potassium channel openers).
In addition, preventative (promptly before autoimmune disease and/or inflammatory diseases outbreak) or therapeutic (promptly during autoimmune disease and/or inflammatory diseases) give CD3 regulator.
In the inventive method, regulator is with the administration of treatment effective dose." the treatment effective dose " of CD3 regulator is meant the required amount of therapeutic purposes that reaches, and described therapeutic purposes for example are treatment autoimmune disease and/or inflammatory diseases, or alleviate the symptom relevant with autoimmune disease and/or inflammatory diseases.
All publications and patent document that this paper quotes are attached to herein by reference, are attached to herein as every piece of this publication or clear and definite and independent being marked as by reference of file.Publication and patent document quote purpose be not admit any its for relevant prior art, do not constitute yet in it perhaps any of date admit.By formal description the present invention of written description, those skilled in the art may appreciate that the present invention can implement with various embodiments, the description of front and following embodiment are for illustrative purposes, rather than the restriction following claim.
Embodiment
Embodiment 1: anti-cd 3 antibodies is used for the treatment of uveitis
Anti-cd 3 antibodies of the present invention comprises the monoclonal antibody (mAb) of various identification CD3, for example OKT3, SP34, UCHTI or 64.1.(referring to for example June, et al, J.Immunol.136:3945-3952 (1986); Yang, et al, J.Immunol.137:1097-1100 (1986); And Hayward, et al, Immunol.64:87-92 (1988)).
Mouse anti rat CD3 monoclonal antibody antibody (BD Pharmingen with purification, be called G4.18 antibody) in can inducing uveitic rat model, test, this model such as Wildner G, Diedrichs-Mohring M, Thurau SR., Eur.J.Immunol.32 (1): 299-306 (2002); With Wildner G, Diedrichs-Mohrmg M, described in Iht.Immunol.15 (8): the 927-35 (2003).The CD3 cell surface antigen reaction that this G4.18 antibody is relevant with TXi Baoshouti, this antigen is found in thymocyte cell, peripheral T lymphocyte and the dendron shape epidermis T cell.(referring to for example Nicolls M.R., et al, Transplantation 55:459-468 (1993); Nelson, D.J., et al, J.Exp.Med.179:203-212 (1994); Morris D.L., and WJ.Komocsar.J.Pharmacol.Toxicol.Methods 37:37-46 (1997)).
In order to evaluate anti-CD3 treatment, in rat, induce experimental autoimmune uveitis (EAU) with intraperitoneal (i.p.) T cell transfer method to uveitic effect.Specifically, in the time of 0 day, female Lewis rat (every heavily about 140 g, n=3 rat/group) accepts 2.4 * 10
6The i.p. injection of individual L37 cell, the PDSAg-2/3 transfection that derives from retina autoantigen S-antigen (SAg) of this cell.
Shift transgenic T cell with before inducing EAU 30 minutes and shift 1,2 and 3 day after, rat is accepted the i.p. injection of the G4.18 antibody (group 2) among 300 μ l phosphate-buffered saline (PBS) solution (group 1) or the 300 μ lPBS.Monitor the clinical uveitis indication of every group of rat every day.Clinical scale standard used herein is only considered preocular inflammation, comes classification with ophthalmofundoscope, and for example as de Smet et al, J.Autoimmun. is described in the vol.6:587 (1993).Listed the clinical scale standard of using in the experiment described herein in the following Table A:
Table A: clinical scale standard
| Grade | Describe |
| 0.5 | The iris pipe enlarges, iris marginal portion inflammatory infiltration and muddy anterior chamber |
| 1.0 | Iris edge annular fully soaks into |
| 2.0 | Lesser ring of Merkel is full of cell and fibrin fully |
| 3.0 | Hypopyon forms |
| 4.0 | Camera oculi anterior is full of cell, fibrin and blood fully |
*Hypopyon=leukocyte is in anterior chamber's bottom deposit, and promptly white is formed sediment.
The 12nd day finishes test, every rat is carried out the destructive Histological evaluation of retina.Histology's standard as herein described is only considered amphiblestroid destruction, according to the frozen section evaluation of treatment after 9 days, for example as document de Smet et al., J.Autoimmun., vol.6:587 (1993)) described in.Used histological grade standard is listed in the table below among the B in the test described herein:
Table B: histological grade standard
| Grade | Describe |
| 0.0 | No inflammatory diseases sign |
| 0.5 | Mild inflammation, the overall complete retina of retina system has inflammatory cell infiltration but does not have the disorganization sign, perhaps there is the impaired focus of exterior light sensor that is less than in 1/4 retina not have granuloma, monocyte infiltration on choroid, corpus ciliare and the retina |
| 1.0 | The impaired destructive focal zone of exterior light sensor in 〉=1/4 retina has photoreceptor and comes off obviously that the retina peripheral vessels soaks into and the vitreous body monocyte infiltration |
| 2.0 | Damaging to have in the slight exudative retina separation of glasses body of retina that expands to outer nuclear layer and 〉=1/4 on a small amount of cytochromes layer to moderate and the retina has Granuloma formation occlusive retinal vasculitis, loses with serious retina separation and photoreceptor |
| 3.0 | The retina retina system that infringement expands to inner nuclear layer and 〉=1/4 begins to lose, a large amount of exudative retinas separate, and wait until in occurring in the vitreous body that a large amount of cells forms the Dalen-Fuchs tuberosity and neovascularization under the retina takes place |
| 4.0 | 〉=1/4 the impaired retina system of retina holostrome retina is destroyed fully |
Begin to occur uveitic clinical symptoms the 3rd day of experiment described herein.Fig. 1 illustrates clinical and histology's effect of uveitis progress in the rat (promptly organizing 1) of accepting PBS and the rat (promptly organizing 2) of the accepting anti-cd 3 antibodies.The result that this paper provides is reported as the meansigma methods of all largest score in whole observing time of this group.
Embodiment 2: anti-cd 3 antibodies is used for the treatment of atherosclerosis
The effect of anti-cd 3 antibodies in the treatment atherosclerosis evaluated with the anti-mice CD3 of hamster antibody.EXPERIMENTAL DESIGN described herein is treated the effect that atheromatous plaque is taken place for estimating anti-CD3, and anti-CD3 treats the effect to the progress for the treatment of existing atherosclerotic lesions.
Generation hamster 145 2C11 monoclonal antibody F (ab ')
2Segmental cell strain is used to estimate the effect of anti-CD3 treatment, and this monoclonal anti physical ability is in conjunction with mice CD3 ε (being the ε chain of Mus CD3 complex).Big male LDLR-of 10 weeks/-the C57BL/6 mice is as Atherosclerosis Model in the body.For the analysis of histology and the generation of tremulous pulse medicated porridge sample lump, and propagation and cytokine analysis, with hypercholesterolemia diet (1.25% cholesterol, 0% cholate) feeding compatriot mice, continued for 13 or 24 weeks.In beginning hypercholesterolemia diet the last week (n=5) (promptly in order to estimate the effect that anti-cd 3 antibodies takes place arteriosclerosis plaque) or beginning back 13 weeks (n=9) (promptly in order to estimate the effect of anti-cd 3 antibodies) to the progress of existing atherosclerotic lesions, continuous 5 days intravenous (i.v.) give anti-CD3 F (ab ')
2(50 μ g/ mice/sky).Control mice is (for 13 all diet n=5; For 24 all diet n=6) parallel injection PBS.
By Sudan IV dyeing lipidosis, analyze the atherosclerotic lesions (Fig. 2 and Fig. 3) in thoracoabdominal aorta and the aortic sinus.From calculate the meansigma methods of the lipidosis of each aortic root each other at a distance of six sections (5 μ m) of 50 μ m.Carry out the quantitative of lipidosis by the computer image analysis of using MetaMorph6 software (Zeiss).The result that this paper provides is expressed as meansigma methods ± s.e.m.Adopt two tail Student ' s T-checks, o'clock think that the difference between numerical value has significance in P＜0.05.
As shown in Figure 2, anti-CD3 treatment suppresses the generation of atherosclerotic plaque in the mice.In addition, Fig. 3 proves that anti-CD3 treatment also reduces further developing that atherosclerotic plaque takes place in (promptly suppressing) existing damage.
Other embodiment
Though the present invention is described in conjunction with specifying, the foregoing description purpose is explanation, and does not limit the scope of the invention, and scope of the present invention is by the scope definition of claims.Others, advantage and modification all are included in the scope of following claim.
Claims (22)
1. method for the treatment of or alleviating the symptom of inflammatory diseases, described method comprise that discriminating has suffered from or the object of the described inflammatory diseases of risky trouble and give described object anti-cd 3 antibodies.
2. the process of claim 1 wherein the expression that the amount of the described anti-cd 3 antibodies that gives is enough to suppress the expression of inflammatory cytokine or increases anti-inflammatory cytokines.
3. the process of claim 1 wherein that the amount of the described anti-cd 3 antibodies that gives is enough to induction of immunity and suppresses.
4. the process of claim 1 wherein that the amount of the described anti-cd 3 antibodies that gives is enough to inducing immune tolerance.
5. the process of claim 1 wherein that described antibody is monoclonal antibody.
6. the method for claim 5, wherein said monoclonal antibody is complete human monoclonal antibodies.
7. the process of claim 1 wherein that described inflammatory diseases is chronic inflammatory disease or acute inflammation disease.
8. the process of claim 1 wherein that described inflammatory diseases is an autoimmune disease.
9. the process of claim 1 wherein that described inflammatory diseases is uveitis, vasculitis or atherosclerosis.
10. the process of claim 1 wherein described to liking people or horse.
11. further comprising, the method for claim 1, described method give described object antiinflammatory or immunosuppressant.
12. the method for claim 11, wherein said antiinflammatory or immunosuppressant are corticosteroid, inhibin, interferon-, NSAID (non-steroidal anti-inflammatory drug) (NSAID), methotrexate, Ciclosporin A or the antirheumatic (DMARD) that changes the state of an illness.
13. the method for claim 12, wherein said Ciclosporin A are ciclosporin microemulsion or tacrolimus.
14. comprising, a method that reduces atheromatous plaque formation on the tremulous pulse, described method give the object anti-cd 3 antibodies.
15. the method for claim 14, the amount of the described anti-cd 3 antibodies that wherein gives are enough to suppress the expression of inflammatory cytokine in the described arterial tissue or increase the wherein expression of anti-inflammatory cytokines.
16. the method for claim 15, wherein said antibody are monoclonal antibody.
17. the method for claim 16, wherein said monoclonal antibody are complete human monoclonal antibodies.
18. a method that suppresses tissue inflammation, described method comprise Inflamed tissue is exposed to anti-cd 3 antibodies.
19. the method for claim 18, the amount of the described anti-cd 3 antibodies that wherein gives are enough to suppress the expression of inflammatory cytokine in the described Inflamed tissue or increase the wherein expression of anti-inflammatory cytokines.
20. the method for claim 18, wherein said antibody are monoclonal antibody.
21. the method for claim 20, wherein said monoclonal antibody are complete human monoclonal antibodies.
22. the method for claim 18, wherein said tissue are vascular tissue or ocular tissue.
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| WO2020081714A1 (en) * | 2018-10-16 | 2020-04-23 | Board Of Regents, The University Of Texas System | Identification and targeting of pathogenic extracellular matrix for diagnosis and treatment of cancer and other diseases |
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| KR20070036035A (en) | 2007-04-02 |
| US20050265993A1 (en) | 2005-12-01 |
| IL209338A0 (en) | 2011-01-31 |
| CA2563260C (en) | 2013-05-28 |
| EP1737490B1 (en) | 2010-06-09 |
| CN1972714B (en) | 2012-10-03 |
| JP2007532565A (en) | 2007-11-15 |
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